Bad Luck’s Role in Cancer: A Talmudic Lesson About Random Chance

A new study claims that many forms of cancer result from bad luck; as I undergo chemotherapy, how should I find meaning in this seeming randomness?

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Several newspapers reported recently that 60 percent of cancer cases result from bad luck rather than bad lifestyles or genes. The original research, published in the medical journal Science, claims that almost two-thirds of adult cancers are caused by random mutations that occur in DNA when cells divide, as they do constantly, with the remaining cancer cases linked to environmental factors or defective inherited genes.

As Professor Bert Vogelstein from the Johns Hopkins University School of Medicine explains, “This study shows that you can add to your risk of getting cancers by smoking or other poor lifestyle factors. However, many forms of cancer are due largely to the bad luck of acquiring a mutation in a cancer driver gene regardless of lifestyle and heredity factors. The best way to eradicate these cancers will be through early detection, when they are still curable by surgery.”

I’m neither a scientist nor an oncologist. But I have a personal interest in the findings. This past summer, I had surgery to remove a large, rare, malignant tumor near my lung. I was 34 years old at the time, and had been married for two months. In early November I began primarily preventative chemotherapy to treat any microscopic cancerous cells that might have remained in my body post-surgery. Perhaps inevitably, this new reality has caused me to ponder the rhyme and reason of life and question what lessons (if any) I should be taking from my situation.

Judaism’s view on why bad things happen is as varied as it is ultimately inconclusive. On the one hand, the classic biblical perspective suggests that what happens to us is inherently connected to the type of people we are, and the extent to which we keep the commandments. On the other hand, there are several stories and ideas that suggest an alternative, more complex reading of both the relationship between how we act religiously and what happens to us, as well as how closely God is involved in our life stories. And one of these narratives is intriguingly similar to the conclusions of the Johns Hopkins scientists.

The Babylonian Talmud's Tractate Moed Katan quotes Rava, one of the rabbinic text's greatest sages, who says that “length of life, children and sustenance depend not on merit but rather on Mazzal."

To demonstrate his point, Rava compares the lives of two righteous rabbis, Rabba and Rav Hisda. Both prayed for rain and it came. But Rav Hisda lived to the age of 92, while Rabba only lived to the age of 40. Sixty marriages were celebrated in Rav Hisda's home, while Rabba's home suffered 60 bereavements. Rav Hisda was wealthy, while Rabbah's family went hungry.

It’s not clear from the story exactly what the Talmudic rabbis mean by the term Mazzal. In those times it probably referred to matters outside of our control or alternatively the order of the stars or even plain luck (although there is a long discussion regarding the extent to which Jews are even affected by these entities). A more contemporary understanding might view it as our genetic disposition, or DNA. Or perhaps other components of our life over which we have no direct influence, such as the socio-economic class or geographical area into which we are born, which in turn affect our potential levels of education, wealth and life expectancy.

Or maybe – as the report in the medical journal Science suggests – mazzal could mean randomness.

The newspaper reports generated criticism from several other articles that disputed the claims. And it’s important to point out that certain cancers that claim the most lives every year – such as certain lung and skin cancers – are connected to our actions and behaviors. Another recent study carried out by Cancer Research UK argued that approximately 600,000 cancers in the U.K. could have been avoided in the past five years if people had healthier lifestyles.

But there may have been an additional motive behind the criticism. Could it be that even if scientifically speaking cancers are primarily caused by random mutations, it's psychologically unhelpful (and even dangerous) for people to encounter their suffering through that prism? They may feel helpless and disempowered, or that their lives are bereft of ultimate meaning. And it might even lead healthy people to neglect their general health and diet, to postpone quitting smoking or beginning exercise. Because if it’s all down to luck, why bother?

In exploring the question of why bad things happen in the world, the late rabbi and philosopher David Hartman argues that the approach of the Talmudic sages belongs more to the realm of religious anthropology than philosophical theology. In other words, it’s less about finding the "truth" (scientific, religious or other) as to why things occur than it is about helping people find meaning, comfort and empowerment in their suffering.

I’m honestly unsure whether pinning a more "direct reason" (divine or otherwise) onto my reality would help or hinder resolving my questions. In any event, I believe it to be challenging to find meaning in potential randomness. But it is somewhat comforting to realize that many (if not all) of these questions have been addressed by Jews throughout the generations, that we form another link in the chain of a Jewish tradition comprised of theological questions and struggles. And that – if nothing else – is meaningful.